Wellness Programs

ROI measurement begins with establishing baseline metrics before the program launches, typically including per-capita medical and pharmacy claims costs, absenteeism rates, short-term disability incidence, and biometric data distributions. ALKEME tracks these metrics over time, adjusting for trend and population changes, to isolate the impact of wellness interventions. We also measure leading indicators such as program participation rates, biometric improvements, HRA risk score changes, and employee engagement survey results. While hard-dollar medical savings often take two to three years to materialize, improvements in engagement, absenteeism, and presenteeism can be observed within the first year.

Yes. Wellness programs that condition incentives on achieving specific health outcomes, known as health-contingent programs, must comply with HIPAA wellness program regulations and ACA nondiscrimination rules. The maximum incentive for a health-contingent program is 30 percent of the total cost of employee-only coverage (50 percent for tobacco cessation programs). Programs must be reasonably designed to promote health, available to all similarly situated individuals, offer reasonable alternative standards for those who cannot meet the health standard due to a medical condition, and provide notice of the alternative standard. Participatory programs that reward employees simply for completing an activity, such as a health screening or educational course, are not subject to these limits. ALKEME designs wellness incentive programs that maximize engagement while maintaining full regulatory compliance.

An Employee Assistance Program (EAP) is a confidential, employer-funded benefit that provides short-term counseling, assessment, and referral services for employees and their household members dealing with personal or work-related challenges. Common issues addressed include stress, anxiety, depression, substance abuse, relationship conflicts, grief, legal concerns, and financial difficulties. Most EAP models provide three to eight counseling sessions per issue per year at no cost to the employee. If ongoing treatment is needed, the EAP clinician refers the employee to an in-network provider under the medical plan. ALKEME helps employers select EAP providers with robust networks, rapid access to appointments, and strong utilization reporting to ensure the benefit is being used effectively.

Employers can strongly encourage participation through incentive structures, but mandatory participation raises legal concerns under HIPAA, the ADA, and GINA. Under current guidance, biometric screenings and health risk assessments must be voluntary, and employees who choose not to participate must not face adverse employment consequences. However, employers can offer meaningful incentives, such as premium discounts, HSA contributions, or gift cards, to encourage participation while providing reasonable alternatives for employees who cannot meet specific health standards. ALKEME designs incentive strategies that drive high participation rates within the boundaries of applicable federal and state regulations.